title: Cancrum oris--a 35-year retrospective study.
abstract: OBJECTIVE
  To determine the factors predisposing to cancrum oris and its frequency, clinical features, treatment and outcome. Cancrum oris is a gangrenous condition of the face usually occurring in poorly nourished children in a Third-World setting.
  
  
  METHODS
  Retrospective review of clinical data on children with cancrum oris.
  
  
  METHODS
  All children with cancrum oris seen over a 35-year period, from 1960 to 1995, at Red Cross War Memorial Children's Hospital (RXH) in Cape Town.
  
  
  METHODS
  Twenty-six patients (16 female and 10 male) with cancrum oris. Their average age at presentation was 4 years and 4 months (range 1-15 years).
  
  
  RESULTS
  The peak incidence was between 1971 and 1975 (11 cases); subsequently only 1 new case was seen at RXH in every 5-year period. Most children were referred from rural areas. Associated conditions could only be determined in 11 of the 26 patients. In order of frequency, these were malnutrition, gastro-enteritis, measles and anaemia. Twenty-three of the 26 children had soft-tissue involvement affecting the lips, cheek, chin, nose or other structures. Eighteen had bony or cartilaginous involvement; the maxilla was affected in 15, the palate in 7, the vomer in 5, the mandible in 3 and the nasal septum in 7. Three children had bony involvement only, the soft tissues being spared. Operative records were available for 18 children. These 18 children had a total of 84 operations, with an average of 4.7 per child (range 0-12).
  
  
  CONCLUSIONS
  Cancrum oris is a devastating condition affecting malnourished children. Reconstruction is complex and demanding, involving both soft tissue (23 of 26 cases) and bone (18 of 26 cases). Most children require multiple procedures. Prevention is best effected by comprehensive primary health care.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Red Cross War Memorial Children's Hospital, Cape Town.
authors.forename: D
authors.initials: D
authors.lastname: Lazarus
authors.forename: D A
authors.initials: DA
authors.lastname: Hudson
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D005145:Face / Q000601:surgery; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D008297:Male; D009625:Noma / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D009748:Nutrition Disorders / Q000150:complications; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D012737:Sex Factors; D013019:South Africa; D016896:Treatment Outcome